A CASE OF HEREDITARY HEMORRHASIC TELANGIECTASIA (RENDU-OSLER-WEBER DISEASE) WITH GASTRIC HEMORRHAGIC LESIONS SUCCESSFULLY TREATED BY ALGON PLASMA COAGULATION

Abstract

A 47-year-old man was admitted to our hospital with the chief complaint of frequent nasal bleeding. Several telangiectatic lesions were observed both on his skin and on his oral mucosa. His father had not only similarly experienced frequent nasal bleeding but also had similar skin lesions as those demonstrated by the patient. We, therefore, made a diagnosis of Hereditary Hemorrhagic Telangiectasia (Rendu-Osler-Weber disease : ROW disease). Upper gastrointesti-nal endoscopy revealed a number of hemorrhagic telangiectasia lesions throughout the stomach which are considered to cause chronic anemia. Argon plasma coagulation was used to treat the hemorrhagic telangiectasia, with which resulted in an improvement of his anemia. He also demonstrated a couple of pulmonary arteriovenus malformations (p-AVM) and multiple hepatic hemangiomatous lesions associated with ROW disease. Since he also suffered from exartional dyspnea with hypoxia due to p-AVM, embolization with platinum coils was performed to treat the p-AVM. The argon plasma coagulation method is considered to be an effective treatment for gastric lesions in ROW disease.